计算机断层扫描在儿科粗腹部创伤:当前的证据,挑战,和未来的方向 - 一个系统的审查和元分析
Mohammed Alsabri1,2, Shree Rath3, Mohamed Amr Elkarargy4
1Emergency Department, Althawara Modern General Hospital, Sanaa, Yemen. alsabritop@yahoo.com.
Scandinavian journal of trauma, resuscitation and emergency medicine
|February 7, 2026
概括
计算机断层扫描 (CT) 对于检测腹内损伤 (IAI) 在儿童中具有敏感. 然而,低的干预和死亡率表明选择性CT使用是适当的,尽量减少辐射暴露.
科学领域:
- 儿科手术 儿科手术
- 紧急医疗 紧急医疗
- 放射学 放射学是一门学科.
背景情况:
- 在儿童中评估腹内损伤 (IAI) 由于体检限制和沟通障碍而存在挑战.
- 计算机断层扫描 (CT) 是敏感的,但引起了人们对辐射暴露和资源使用的担忧.
- 这项研究系统地审查了儿童形腹部创伤的CT使用情况.
研究的目的:
- 量化IAI的患病率在CT评估的孩子们的的腹部创伤.
- 描述特定器官的损伤模式.
- 评估与CT检测到的IAI相关的干预和死亡结果.
主要方法:
- 15项研究 (7,430名儿童) 的系统综述和贝叶斯随机效应元分析.
- 搜索了PubMed,科学网,科克兰图书馆和Scopus.
- 使用GRADE框架来评估证据的确定性.
主要成果:
- 综合IAI患病率为84.5% (95% CrI:62-94%),干预概率为7.7%,死亡率为1.4%.
- 固体器官损伤 (肝脏,肠道,脏,脏) 是最常见的.
- 亚组分析显示,在更广泛的创伤人群中,IAI的概率较低.
结论:
- 对IAI来说,CT非常敏感,但低的干预/死亡率支持以决策规则为指导的选择性使用.
- 尽量减少常规CT成像,以减少辐射风险.
- 未来的研究应该集中在前性研究,决策工具实施和非电离成像替代方案上.
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